Pneumonia Clinical Trial
Official title:
Improving and Evaluation of a New Cross-sectoral Hospital at Home Model for Elderly Acute Ill Patients
Many elderly patients with uncomplicated treatment courses are admitted unnecessarily, which is a burden for the patient and society. Studies show that Hospital at Home (HaH) treatment is an alternative to hospitalization. The patient's risk of delirium, infection and loss of function is reduced when the patient avoids the hospital stay. HaH treatment is expected to be more cost-effective, improve patients' functional abilities and patients' satisfaction. Three municipalities, general practitioners, pre-hospital service and an emergency department (ED) in Central Denmark Region have organized the first HaH treatment model across disciplines and sectors. Specialists in the ED and the municipal acute teams provide HaH treatment for elderly acute ill patients. However, the model has not yet been evaluated. The aim of this study is to optimize the HaH treatment model for elderly acute ill patients. The objective is to increase patient satisfaction and optimize the use of resources in healthcare by avoiding unnecessary hospitalizations that impair and prolong treatment. This study is an open label randomized controlled trial (RCT) with a 1:2 allocation ratio of acute hospital admission versus HaH. During a pilot period, we tested and adapted the patient pathway of HaH to the practical reality, before we start the randomization for the RCT study. We will investigate the clinical effects and health economic consequences of HaH treatment compared with standard hospital treatment.
Status | Recruiting |
Enrollment | 849 |
Est. completion date | August 2027 |
Est. primary completion date | August 2027 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 65 Years and older |
Eligibility | Inclusion Criteria: - The patient should be aged 65 and over - The patient should be living in their own home or a nursing home before entering the study - The patient should be residing in one of the three municipalities (Viborg, Skive and Silkeborg) - The patient must have been seen by the GP or the pre-hospital service in the case of disease in question - The patient should speak and understand Danish. - The patient should give informed consent to participate in the study. Exclusion Criteria: - The patient is unable to give written consent - The capacity of the municipal acut team care was fully utilised. |
Country | Name | City | State |
---|---|---|---|
Denmark | Silkeborg municipality | Silkeborg | |
Denmark | Skive municipality | Skive | |
Denmark | Viborg municipality | Viborg |
Lead Sponsor | Collaborator |
---|---|
Defactum, Central Denmark Region | Interdisciplinary Centre for Organizational Architecture (ICOA), Aarhus University, Denmark, Research Center for Emergency Medicine, Aarhus University, Denmark, Viborg Regional Hospital |
Denmark,
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Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Rate of 30-days re-admission | Rate of 30-days re-admission after discharge | 30 days period after discharge | |
Primary | Health Related Quality of Life | Estimating quality of life by using EuroQoL-5 Dimensions. We will use EuroQoL-5 Dimensions to measure Health Related Quality of Life. The five dimensions include mobility, self-care, usual activity, pain/discomfort and anexiety/depression.This tool will provide us with health states (11111 being the best health state and 55555 the worse health state). We will use the Danish weight to give weights to different health states obtained from EuroQoL-5 Dimensions. | From inclusion to 3 months follow-up | |
Secondary | Functional mobility test | Estimating basic functional mobility by using Timed Up and Go (TUG) | From inclusion to 3 months follow-up | |
Secondary | Mortality rate | Estimating mortality rate for the study population using the National Registries | From inclusion to 3 months follow-up | |
Secondary | Number of contacts to primary and secondary health care system | The Danish National Registries will be used to estimate number of contacts to the primary and secondary healthcare for both control and intervention groups. | From inclusion to 3 months follow-up |
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